Individual
YAZAN FAHMAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 CHARLES ST STE 405, ROCKFORD, IL 61104-2200
(779) 696-6102
(779) 696-6026
Mailing address
2550 CHARLES ST, ROCKFORD, IL 61108-1673
(779) 696-7019
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036-167640
IL
207RP1001X
Pulmonary Disease Physician
MD.42858
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2018
Last updated
04/14/2026
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